Six months of exclusive breast feeding: how good is the evidence?

BMJ 2011; 342 doi: (Published 13 January 2011) Cite this as: BMJ 2011;342:c5955

Infection is (much) more important than anaemia or allergy

It seems extraordinary that concern about possible effects on iron
deficiency and coeliac disease should lead the authors of this review to
suggest shortening the recommended duration of exclusive breast feeding
(EBF), when they themselves acknowledge that longer durations of EBF are
associated with substantial reductions in infectious diseases. There is
now excellent research evidence that this applies to children in affluent
as well as deprived societies.(1;2). Visit any UK paediatric ward and you
will find them teeming with infants with infections, not iron deficiency
and coeliac disease. It is inevitable that there will be harms as well as
benefits associated with deferring solids and the WHO determined the age
at which equipoise between the two was reached.

It also seems extraordinary that the BMJ would publish this highly
subjective article in the same issue in which they repeatedly castigated
the Lancet for its behaviour in relation to MMR. Many children will lose
the protective benefit of breast milk as result of their inflammatory
publcity and become ill as a result. Will the BMJ next mount an expose of
its own irresponsibility?

(1) Wright CM, Parkinson K, Scott J. Breast-feeding in a UK urban
context: who breast-feeds, for how long and does it matter? Public Health
Nutr 2006; 9(6):686-691.

(2) Ladomenou F, Moschandreas J, Kafatos A, Tselentis Y, Galanakis E.
Protective effect of exclusive breastfeeding against infections during
infancy: a prospective study. Arch Dis Child 2010; 95(12):1004-1008.

Competing interests: No competing interests

01 February 2011
Charlotte M Wright
Professor of Community Child Health
Glasgow University